Member Application Form,Return this form WITH payment to: NWGA, PO Box 4928, Portland OR 97208 OR deliver in person to an event. All information is kept confidential.

Please type or print clearly:

TG Name____________________________Date____________Membership Type: □ Regular □ Honorary* □ Scholarship □ New Annual dues are $40 (or $45 if you elect to have a hard copy of ​the newsletter mailed to you.) Would you like a hard copy mailed to you? □ No □ Yes Would you like confirmation of payment? □ No □ Yes